Re: Need Help – Saliva Test Interpretation

June 22, 2007

>

> Hi All,

> I am new to the group. I've been reading through the archives for

> quite some time though. You all have made me aware of a lot & are

> all very knowledgeable. Thank you!

>

> I just got my saliva test results and am wondering if you all could

> help me interpret them. They have totally thrown me as they are not

> what I expected from my research & symptoms. I am confused.

>

> From the way I feel (can't get up in morning & have a hard time going

> to sleep at night) I was expecting to have low morning & high evening

Did you have that pattern of symptoms on the day of the test?

Any better or worse than usual?

Your morning result of 18 is just below the middle of the range, but

the " normal range " may not apply to your situation. If your body is

under physiological stress, it needs more cortisol. The normal range

is a generality, and may not reflect the amount of cortisol you need

at this point in your healing process. (You haven't indicated your

diagnosis or your status as far as amalgam removal and chelation,

but I assume you are here for a reason...)

Your total cortisol burden for the day is quite low in the range.

As to nighttime, can you describe the nature of your trouble going to

sleep? Do you feel wide awake and don't feel like sleeping, do you

feel very tired, but can't fall sleep? Do you wake up a lot? Do

you have other symptoms that go along with sleep difficulty (emotions,

digestive issues, pain, etc)?

> cortisol, but that's not the case. My morning collection ended at

> 8:30am b/c it took much longer then I thought to work up all that

> saliva – do you think that threw off my morning results? I also took

I don't know. I have that problem, too. I have heard it is

common when your adrenals are fatigued, but I don't know if there

is a reason why that would be true. Maybe someone else can comment.

> a proton pump inhibitor med the night before & around 9pm the night

> of the test. I know it said no antacids, but didn't think a proton

> pump inhibitor & antacid were the same thing (different chemical

> makeups). They aren't for the purposes of this test, are they?

I wouldn't think of a PPI as an antacid, but it is hard to be sure

what they mean - you might call the company and ask them whether

a PPI or acid blocker would cause a problem, and if so, would it

affect the result in a predictable way.

Just

> wondering if I messed up the test & that is why my results are so

> odd. My cortisol pattern doesn't seem to fit any of the adrenal

> fatigue stages.

> So anyway according to the cortisol-DHEA correlation graph I am in

> the reference range however my little dot is right on the line to

> zone 5. Does that mean I'm close to zone 5 adrenal fatigue? I know

> I'm not normal as the test suggests. I'm tired all the time & have a

> lot of other symptoms too.

I think stage 5 is a pretty good fit to the general pattern of

your results, regardless of where the dot falls.

> The circadian cortisol profile graph shows me right in the middle for

> 8am, low (touching the line) for noon, below the reference range for

> 4pm, and once again touching the bottom line for midnight.

>

> How do I go about dosing adrenal support such as licorice,

> pregnenolone, pantethine or Isocort for this? I guess I don't take

> it in the am but rather at noon, 4pm & around 10-10:30pm for the

> midnight reading? Dosing at night seems counter-intuitive to me

> since I have trouble falling & staying asleep. I guess I would take

> my largest dose at the 4pm time period?

Don't skip the morning. Your symptoms say you need support in the

morning, so try it and see how you feel with some Isocort or licorice

in the am.

Hydrocortisone seems to work better for some people. You will have

to see what works for you.

I am not sure of dosing for pregnenolone, as I haven't used it yet.

For Isocort or hydrocortisone, I would try to follow a desirable

cortisol curve, dosing most in the morning, less at noon, and

little in the afternoon.

For licorice, I've usually seen recommendations for about 1/4

teaspoon of solid extract 2-3 times per day, and I have used it

that way.

> I also bought some DHEA, but haven't started on it yet. Now seeing

> my results I guess DHEA probably wouldn't even be helpful?

I'm not sure about this.

> I also have some ashwagandha, which I haven't started yet either.

> But have read that it may not be good for those with Hashimoto's,

> which I guess I have based on TPO positive. Any thoughts on this?

I really felt good on ashwagandha, but eventually I started having

symptoms that seemed possibly autoimmune. I think it is a concern

and I am reluctant to use now for this reason.

> Also, my thyroid. I think this mean's that I have Hashimoto's. Does

> it also mean that I am hypothyroid as it seems they go hand in hand

> but maybe not always? I found a copy of Dr. Rind's thyroid scale

> that Dean had done for saliva tests in post #16818 (since the one on

> Dr. Rind's site looks like it's more for blood test results rather

> than saliva), plugged my #'s in & looked at Dr. Rind's Thyroid Scale

> interpretation matrix to make sense of it. It doesn't seem to fit

> any of his patterns. So I'm confused b/c I really thought I was

> going to come up hypothyroid. Can anyone shed any light on this? On

> the thyroid scale my TSH is at the +3/+4 interval, FT4 is at +4 while

> my FT3 is at -9.

If you post the ranges for your thyroid results, we can make more

informed comments. I'm guessing from what you say above that you

may have a conversion problem.

--

> Any help anyone could give would be appreciated!

>

> Thanks so much,

> Sam

>

> 7:00 – 8:00 am -- 18 normal (range 13-24)

> 11:00 – noon – 6 normal (range 5-10)

> 4:00 – 5:00 pm – 1 depressed (range 3-8)

> 11:00 – Midnight – 1 normal (range 1-4)

> Cortisol burden – 26 (range 23 – 42)

>

> DHEA 7 normal (range 3-10)

>

> Estradiol 10

> Progsterone 53

> Free Testosterone 12 normal

>

> TSH 65 normal

> Ft4 .34 normal

> Ft3 .33 normal

> TPO Positive

>

June 22, 2007

Hi ,

*****My replies are below.

> >

> > Hi All,

> > I am new to the group. I've been reading through the archives

for

> > quite some time though. You all have made me aware of a lot &

are

> > all very knowledgeable. Thank you!

> >

> > I just got my saliva test results and am wondering if you all

could

> > help me interpret them. They have totally thrown me as they are

not

> > what I expected from my research & symptoms. I am confused.

> >

> > From the way I feel (can't get up in morning & have a hard time

going

> > to sleep at night) I was expecting to have low morning & high

evening

>

> Did you have that pattern of symptoms on the day of the test?

***** I would say yes.

> Any better or worse than usual?

***** I really don't know. Sometimes i can get up easier earlier

than others. It depends how much sleep i got that night. That

morning I just made myself get up so I could do the test. I got up

at about 7:45am.

>

> Your morning result of 18 is just below the middle of the range,

but

> the " normal range " may not apply to your situation. If your body

is

> under physiological stress, it needs more cortisol. The normal

range

> is a generality, and may not reflect the amount of cortisol you

need

> at this point in your healing process. (You haven't indicated your

> diagnosis or your status as far as amalgam removal and chelation,

> but I assume you are here for a reason...)

*****I did a hair test & met 2 counting rules. I had my amalgams

removed about a month ago. And have been chelating according to Andy

Culter's method since.

>

> Your total cortisol burden for the day is quite low in the range.

*****Is it supposed to be in the middle or upper part of the range?

>

> As to nighttime, can you describe the nature of your trouble going

to sleep? Do you feel wide awake and don't feel like sleeping, do

you

> feel very tired, but can't fall sleep? Do you wake up a lot? Do

> you have other symptoms that go along with sleep difficulty

>(emotions,digestive issues, pain, etc)?

>

***** In general - tired but not tired enough to sleep. Sometimes

pretty wide awake. Don't go to bed till late (12-1am is good for me

unfortunately) b/c if I go too early i'll never fall asleep - my mind

won't shut off. I am also easily startled by sound so I need

complete quiet & am a light sleeper. I also tend to wake at night &

stay awake, once again b/c my mind won't shut off. I go through

spells of waking at a specific time at night. So then waking & not

sleeping at night I finally fall asleep in morning hours. I always

tend to wake alot from 6am on but then get really tired and fall off

again & have light morning sleep & dream alot.

*****But since chelating my sleeping habits are harder to try to keep

a rythm to b/c now i intentionally mess myself up every weekend.

Even when i wasn't chelating i would go thru spells of waking at the

same time(s) every night -- until i finally would manage to break it

w/sleeping pills. But then they make it hard to get out of bed in

morning.

*****A good night is 5 hrs straigh & then a bunch of broken sleep.

currently i take tryptophan, melatonin, valerin, magnesium &

chamomile tea at bedtime. Without them i don't think i'd fall

asleep. Every now & then i do in front of the TV but then wake at

around 4:30 anyway & stay awake in a stupor.

>

> > cortisol, but that's not the case. My morning collection ended

at

> > 8:30am b/c it took much longer then I thought to work up all that

> > saliva – do you think that threw off my morning results? I also

took

>

> I don't know. I have that problem, too. I have heard it is

> common when your adrenals are fatigued, but I don't know if there

> is a reason why that would be true. Maybe someone else can comment.

>

> > a proton pump inhibitor med the night before & around 9pm the

night

> > of the test. I know it said no antacids, but didn't think a

proton

> > pump inhibitor & antacid were the same thing (different chemical

> > makeups). They aren't for the purposes of this test, are they?

>

> I wouldn't think of a PPI as an antacid, but it is hard to be sure

> what they mean - you might call the company and ask them whether

> a PPI or acid blocker would cause a problem, and if so, would it

> affect the result in a predictable way.

>

> Just

> > wondering if I messed up the test & that is why my results are so

> > odd. My cortisol pattern doesn't seem to fit any of the adrenal

> > fatigue stages.

>

> > So anyway according to the cortisol-DHEA correlation graph I am

in

> > the reference range however my little dot is right on the line to

> > zone 5. Does that mean I'm close to zone 5 adrenal fatigue? I

know

> > I'm not normal as the test suggests. I'm tired all the time &

have a

> > lot of other symptoms too.

>

> I think stage 5 is a pretty good fit to the general pattern of

> your results, regardless of where the dot falls.

>

> > The circadian cortisol profile graph shows me right in the middle

for

> > 8am, low (touching the line) for noon, below the reference range

for

> > 4pm, and once again touching the bottom line for midnight.

> >

> > How do I go about dosing adrenal support such as licorice,

> > pregnenolone, pantethine or Isocort for this? I guess I don't

take

> > it in the am but rather at noon, 4pm & around 10-10:30pm for the

> > midnight reading? Dosing at night seems counter-intuitive to me

> > since I have trouble falling & staying asleep. I guess I would

take

> > my largest dose at the 4pm time period?

>

> Don't skip the morning. Your symptoms say you need support in the

> morning, so try it and see how you feel with some Isocort or

licorice

> in the am.

*****I was, before i saw these results, taking licorice in the am. I

don't think it did much for me in the am (since i was still in bed

around 11am & forced myself up). But i wasn't taking it at night

either since i thought it would make me REALLY awake. -- Later in

the day (afternoon hrs) it was somewhat helpful. I've just started

trying some at night too but stopped the morning. So, i guess i'll

try it throughout the day?

>

> Hydrocortisone seems to work better for some people. You will have

> to see what works for you.

***** I want to try to find a doctor that can help me with this

mess. I saw the source i could buy some HC & try for myself, but i'm

a bit nervous about it.

>

> I am not sure of dosing for pregnenolone, as I haven't used it

yet.

>

> For Isocort or hydrocortisone, I would try to follow a desirable

> cortisol curve, dosing most in the morning, less at noon, and

> little in the afternoon.

*****Ok. I just got really confused when i saw my results and they

didn't look like anyone elses that was mercury toxic that i read

about. It doesn't seem that anything about me or my life w/this

stuff is normal. Say if i did Isocort according to this schedule

http://www.stopthethyroidmadness.com./community/viewtopic.php?t=994

would that be good? It has a nighttime dose too. I guess i should

get the nighttime cortisol up too since that is low?

>

> For licorice, I've usually seen recommendations for about 1/4

> teaspoon of solid extract 2-3 times per day, and I have used it

> that way.

>

> > I also bought some DHEA, but haven't started on it yet. Now

seeing

> > my results I guess DHEA probably wouldn't even be helpful?

>

> I'm not sure about this.

>

> > I also have some ashwagandha, which I haven't started yet

either.

> > But have read that it may not be good for those with Hashimoto's,

> > which I guess I have based on TPO positive. Any thoughts on this?

>

> I really felt good on ashwagandha, but eventually I started having

> symptoms that seemed possibly autoimmune. I think it is a concern

> and I am reluctant to use now for this reason.

>

> > Also, my thyroid. I think this mean's that I have Hashimoto's.

Does

> > it also mean that I am hypothyroid as it seems they go hand in

hand

> > but maybe not always? I found a copy of Dr. Rind's thyroid scale

> > that Dean had done for saliva tests in post #16818 (since the one

on

> > Dr. Rind's site looks like it's more for blood test results

rather

> > than saliva), plugged my #'s in & looked at Dr. Rind's Thyroid

Scale

> > interpretation matrix to make sense of it. It doesn't seem to

fit

> > any of his patterns. So I'm confused b/c I really thought I was

> > going to come up hypothyroid. Can anyone shed any light on

this? On

> > the thyroid scale my TSH is at the +3/+4 interval, FT4 is at +4

while

> > my FT3 is at -9.

>

> If you post the ranges for your thyroid results, we can make more

> informed comments. I'm guessing from what you say above that you

> may have a conversion problem.

*****Oops --> Sorry. I've added it, pls see below.

***** so if my adrenals are properly supported might that help the

conversion of T3 to T4 along? Maybe even enough to be normal w/o

thyroid meds?

Thanks Again!!

>

> --

>

> > Any help anyone could give would be appreciated!

> >

> > Thanks so much,

> > Sam

> >

> > 7:00 – 8:00 am -- 18 normal (range 13-24)

> > 11:00 – noon – 6 normal (range 5-10)

> > 4:00 – 5:00 pm – 1 depressed (range 3-8)

> > 11:00 – Midnight – 1 normal (range 1-4)

> > Cortisol burden – 26 (range 23 – 42)

> >

> > DHEA 7 normal (range 3-10)

> >

I'm guessing on what I've looked up that I was in the Follicular

phase of my cycle. Took the test 12 days after the start of my last

period.

> > Estradiol 10 (Follicular: 5-13 pg/ml ----- Luteal: 7-20 pg/ml)

> > Progsterone 53 (Follicular: 20-100 pg/ml ----- Luteal: 65-500

pg/ml)

> > Free Testosterone 12 normal

> >

> > TSH 65 normal -->(Borderline Low: 20-25 nlU/ml -- Normal: 26-85

nlU/ml --Borderline High: 86-120 nlU/ml)

> > Ft4 .34 normal --> (Normal: 0.17-0.42 ng/dl)

> > Ft3 .33 normal --> (Borderline Low: 0.21-0.27 gp/ml -- Normal:

0.28-1.10 pg/ml)

> > TPO Positive

> >

>

June 23, 2007

> > >

> > > From the way I feel (can't get up in morning & have a hard time

> going

> > > to sleep at night) I was expecting to have low morning & high

> evening

> >

>

> > Did you have that pattern of symptoms on the day of the test?

> ***** I would say yes.

> > Any better or worse than usual?

> ***** I really don't know. Sometimes i can get up easier earlier

> than others. It depends how much sleep i got that night. That

> morning I just made myself get up so I could do the test. I got up

> at about 7:45am.

Making yourself get up at 7:45 am to do the test may have resulted

in a higher cortisol level than you normally have. If you can

remember what your experience was like that morning - whether doing

the saliva test was a breeze vs you were struggling with the

instructions, fumbling with the tubes, finding the whole process

overwhelming - that will tell you something about whether your

cortisol level that morning was sufficient for your needs.

Your levels were low for the rest of the day - perhaps because you

burned yourself out with your morning efforts.

My point is that reference ranges aren't everything. You need to

take your symptoms into account, too.

> > Your morning result of 18 is just below the middle of the range,

> but

> > the " normal range " may not apply to your situation. If your body

> is

> > under physiological stress, it needs more cortisol. The normal

> range

> > is a generality, and may not reflect the amount of cortisol you

> need

> > at this point in your healing process. (You haven't indicated your

> > diagnosis or your status as far as amalgam removal and chelation,

> > but I assume you are here for a reason...)

>

> *****I did a hair test & met 2 counting rules. I had my amalgams

> removed about a month ago. And have been chelating according to Andy

> Culter's method since.

>

> >

> > Your total cortisol burden for the day is quite low in the range.

> *****Is it supposed to be in the middle or upper part of the range?

Again, reference ranges aren't everything. Just because it is in

the reference range doesn't mean it was enough for you, either in

general or on that particular day.

Also the vast majority of your cortisol for the day was in the

morning. It suggests you spent your capacity on the morning.

Ordinary physiological processes require more cortisol than

you were making over the course of the day. You really need

some support.

> > As to nighttime, can you describe the nature of your trouble going

> to sleep? Do you feel wide awake and don't feel like sleeping, do

> you

> > feel very tired, but can't fall sleep? Do you wake up a lot? Do

> > you have other symptoms that go along with sleep difficulty

> >(emotions,digestive issues, pain, etc)?

> >

> ***** In general - tired but not tired enough to sleep. Sometimes

> pretty wide awake. Don't go to bed till late (12-1am is good for me

> unfortunately) b/c if I go too early i'll never fall asleep - my mind

> won't shut off. I am also easily startled by sound so I need

> complete quiet & am a light sleeper. I also tend to wake at night &

> stay awake, once again b/c my mind won't shut off. I go through

> spells of waking at a specific time at night. So then waking & not

> sleeping at night I finally fall asleep in morning hours. I always

> tend to wake alot from 6am on but then get really tired and fall off

> again & have light morning sleep & dream alot.

I recognize some of this.

For sound sensitivity, I use ear plugs. Is your room nice and dark?

That can help. Certain yoga postures or qigong can be very helpful.

It is possible that you do have high cortisol at night, even though

the saliva test doesn't show it. The last saliva collection is

at 11 pm - who knows what happens during the night. My last saliva

test was low at all four time points, but I was hardly sleeping

at all and it seems possible that I was making cortisol at night.

Taking phosphatidyl serine can help with this.

If the thoughts running through your mind are obsessive and

worrying, 5HTP might be helpful. GABA can help you relax and

relieves anxiety or anxious thoughts.

> *****But since chelating my sleeping habits are harder to try to keep

> a rythm to b/c now i intentionally mess myself up every weekend.

> Even when i wasn't chelating i would go thru spells of waking at the

> same time(s) every night -- until i finally would manage to break it

> w/sleeping pills. But then they make it hard to get out of bed in

> morning.

>

> *****A good night is 5 hrs straigh & then a bunch of broken sleep.

> currently i take tryptophan, melatonin, valerin, magnesium &

> chamomile tea at bedtime. Without them i don't think i'd fall

> asleep. Every now & then i do in front of the TV but then wake at

> around 4:30 anyway & stay awake in a stupor.

Are you using a timed-release melatonin? I think Andy says somewhere

that a combination of regular and timed-release works well. I haven't

tried that.

I have used Benadryl (could use any of the sedating antihistamines)

to help with sleep. You can also go the Rx route.

Habits make a big difference. Having a set schedule for when you

go to sleep and get up, as well as appropriate activity choices

to prepare you for sleep in the evening make a big difference.

> > Don't skip the morning. Your symptoms say you need support in the

> > morning, so try it and see how you feel with some Isocort or

> licorice

> > in the am.

> *****I was, before i saw these results, taking licorice in the am. I

> don't think it did much for me in the am (since i was still in bed

> around 11am & forced myself up). But i wasn't taking it at night

> either since i thought it would make me REALLY awake. -- Later in

> the day (afternoon hrs) it was somewhat helpful. I've just started

> trying some at night too but stopped the morning. So, i guess i'll

> try it throughout the day?

I think if you're going to use licorice, you should use it

consistently 2-3 times daily for a week and then evaluate whether

it makes a difference for you.

I think you are more likely to get the benefits you need with

some HC or possibly Isocort.

> > Hydrocortisone seems to work better for some people. You will have

> > to see what works for you.

> ***** I want to try to find a doctor that can help me with this

> mess. I saw the source i could buy some HC & try for myself, but i'm

> a bit nervous about it.

I have only used Rx, so no experience with this.

> > I am not sure of dosing for pregnenolone, as I haven't used it

> yet.

> >

> > For Isocort or hydrocortisone, I would try to follow a desirable

> > cortisol curve, dosing most in the morning, less at noon, and

> > little in the afternoon.

> *****Ok. I just got really confused when i saw my results and they

> didn't look like anyone elses that was mercury toxic that i read

> about. It doesn't seem that anything about me or my life w/this

> stuff is normal. Say if i did Isocort according to this schedule

> http://www.stopthethyroidmadness.com./community/viewtopic.php?t=994

> would that be good? It has a nighttime dose too. I guess i should

> get the nighttime cortisol up too since that is low?

I think that is a reasonable schedule to try. Like anything else,

you may have to customize the details to your own needs.

Some people say they need a little HC at night to help them sleep.

You will have to see what works for you.

> I'm guessing on what I've looked up that I was in the Follicular

> phase of my cycle. Took the test 12 days after the start of my last

> period.

> > > Estradiol 10 (Follicular: 5-13 pg/ml ----- Luteal: 7-20 pg/ml)

> > > Progsterone 53 (Follicular: 20-100 pg/ml ----- Luteal: 65-500

> pg/ml)

Using some progesterone cream could help a lot with sleep. Many

women can benefit from it. You could do a female hormone panel over

the course of a month if you want test results to confirm a need.

Or you could just try using it for the last 2-3 weeks of your

cycle for a couple of months to decide if it is going to help.

> > > Free Testosterone 12 normal

> > >

> > > TSH 65 normal -->(Borderline Low: 20-25 nlU/ml -- Normal: 26-85

> nlU/ml --Borderline High: 86-120 nlU/ml)

> > > Ft4 .34 normal --> (Normal: 0.17-0.42 ng/dl)

> > > Ft3 .33 normal --> (Borderline Low: 0.21-0.27 gp/ml -- Normal:

> 0.28-1.10 pg/ml)

> > > TPO Positive

Start some adrenal support first. I think you would most likely

do best on HC. If you want to find a doctor to Rx it, you may

be able to get a recommendation for someone in your area by asking

here or on one of the NTH groups. Or you can go to the Armour

website (or other thyroid-related websites) and search for a doc

in your area. Some people feel good on Isocort, so you could

always try that - might be faster to get than HC.

It is worth trying selenium anyway, since it is a good chelation

supplement. It may help with conversion and can be helpful to

suppress antibodies.

You probably need both Armour and HC. You will feel a lot better

when you get these.

--

June 23, 2007